{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:21:22Z","timestamp":1783405282238,"version":"3.54.6"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"\n Objective<\/jats:title>\n To evaluate the effectiveness of an intelligent clinical decision support system (CDSS) for neonatal hypoglycemia management in mother-infant rooming-in settings, and to dissect the differential hypoglycemia risk conferred by individual high-risk factors and their specific combinations under standardized surveillance.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A multidisciplinary team developed a knowledge-driven CDSS grounded in national expert consensus, integrating automated maternal-neonatal risk identification, dynamic tiered monitoring reminders, and structured stratified management recommendations. Effectiveness was assessed using a pre-post self-controlled analysis (historical control: January\u2013March 2024,\n n<\/jats:italic>\n \u2009=\u2009522; CDSS-implemented: April\u2013June 2024,\n n<\/jats:italic>\n \u2009=\u2009417) and a concurrent parallel controlled analysis (non-CDSS wards:\n n<\/jats:italic>\n \u2009=\u2009389; CDSS wards:\n n<\/jats:italic>\n \u2009=\u2009352). Neonatal hypoglycemia was defined as blood glucose &lt;2.2\u2005mmol\/L. Risk factor combination patterns were explored among 6,667 system-flagged high-risk neonates.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n CDSS implementation significantly reduced hypoglycemia incidence in both the pre-post (5.76% vs. 11.88%,\n P<\/jats:italic>\n \u2009&lt;\u20090.05) and parallel (5.40% vs. 9.25%,\n P<\/jats:italic>\n \u2009&lt;\u20090.05) analyses. Under CDSS-managed surveillance, the overall hypoglycemia incidence in the high-risk cohort was 6.3%. Marked heterogeneity was observed: preterm birth (15.4%) and low birth weight (25.0%) carried the highest independent risks, while risk escalated non-linearly with specific factor combinations, reaching 18.8% in neonates with five concurrent factors. Serial monitoring demonstrated a sharp decline in hypoglycemia incidence from 6.1% at first measurement to \u22640.4% thereafter.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The intelligent CDSS effectively reduces neonatal hypoglycemia in rooming-in settings. Hypoglycemia risk depends more on the specific types and combinations of high-risk factors than on their quantity alone, providing evidence for precise risk stratification. This closed-loop, guideline-driven workflow enhances clinical standardization and patient safety. Future multicenter studies incorporating machine learning and long-term neurodevelopmental follow-up are warranted.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fped.2026.1798686","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:48:15Z","timestamp":1783403295000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Closed loop construction of hypoglycemia risk management for high risk neonates in mother infant rooming in settings: a retrospective study with an embedded clinical decision support system"],"prefix":"10.3389","volume":"14","author":[{"given":"Limin","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Shaoxing Maternity and Child Health Care Hospital (Maternity and Child Health Care Affiliated Hospital, Shaoxing University)","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Infectology, Shaoxing Maternity and Child Health Care Hospital (Maternity and Child Health Care Affiliated Hospital, Shaoxing University)","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beimeng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Shaoxing Maternity and Child Health Care Hospital (Maternity and Child Health Care Affiliated Hospital, Shaoxing University)","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Information Technology, Shaoxing Maternity and Child Health Care Hospital (Maternity and Child Health Care Affiliated Hospital, Shaoxing University)","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caixia","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Shaoxing Maternity and Child Health Care Hospital (Maternity and Child Health Care Affiliated Hospital, Shaoxing University)","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2077","DOI":"10.1016\/S0140-6736(13)61645-1","article-title":"Dextrose gel for neonatal hypoglycaemia (the sugar babies study): a randomised, double-blind, placebo-controlled trial","volume":"382","author":"Harris","year":"2013","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1001\/jamapediatrics.2017.1579","article-title":"Association of neonatal glycemia with neurodevelopmental outcomes at 4.5 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